Te Urutanga Mai: Enrolment

Before submitting the form, below please make sure that the obligatory fields marked with * are filled in correctly.

Enrolment Form

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Student Details - Step 1 of 11

Student Details

Student's legal name *

First

Middle

Last

Student's preferred name

Date of birth *//

Gender *

Male

Female

Address *

Address Line 1

City

State / Province / Region

Postal Code

Student's mobile number *

Current school attending *

Current year level *

Ethnicity *

Iwi (3 maximum) *

Is enrolment for this year? *

Yes

No

Is this enrolment for next year? *

Yes

No

Any siblings at this kura? *

Yes

No

If yes, please add the name of sibling(s) below

Name of siblings

Medical Details

Does the student have a doctor? *

Yes

No

Doctor's name *

Doctor's address *

Address Line 1

City

State / Province / Region

Doctor's phone number *

Does the student have a dentist? *

Yes

No

Dentist's name *

Dentist's phone number *

Does student suffer from any of the following medical conditions?

ADHD *

Yes

No

If yes, state medication for ADHD

Allergies *

Yes

No

If yes, state medication for Allergies

Asthma *

Yes

No

If yes, state medication for Asthma

Depression *

Yes

No

If yes, state medication for Depression

Diabetic *

Yes

No

If yes, state medication for Diabetic

Gluten *

Yes

No

If yes, state medication for Gluten

Hearing *

Yes

No

If yes, state medication for Hearing

Heart Conditions *

Yes

No

If yes, state medication

Lactose *

Yes

No

If yes, state medication

Learning disorders *

Yes

No

If yes, state medication

Peanuts *

Yes

No

If yes, state medication

Sleep disorder *

Yes

No

If yes, state medication

Visual impaired *

Yes

No

If yes, state medication

Other *

Yes

No

If yes, state condition and medication

Does this student have reactions to any of the following?

If required, please send labelled medication to the School Nurse for reqular use or for emergencies such as antihistamines for bee stings. Please note our School Nurse is not-full-time at our school.

Anaesthetics *

Yes

No

If yes, state what is required to be done for Anaesthetics

Aspirin *

Yes

No

If yes, state what is required to be done for Aspirin

Bee/wasp stings *

Yes

No

If yes, state what is required to be done for Aspirin

Codeine *

Yes

No

If yes, state what is required to be done for Codeine

Food allergy *

Yes

No

If yes, state food type

Penicillin *

Yes

No

If yes, state what is required to be done

Sulfa *

Yes

No

If yes, state what is required to be done

Sunlight *

Yes

No

If yes, state what is required to be done

Other *

Yes

No

If yes, state condition and what is required to be done

Is this student immunised? *

Yes

No

If yes, we require an immunisation report.

Upload immunisation report file *

Legal Caregiver Details

(Female) Who student normally resides with

Is there a female Legal Caregiver? *

Yes

No

Who student normally resides with

Title *

Mrs

Miss

Ms

Name *

First

Last

Status *

Solo parent

Single

Married

De-facto

Other (please state)

If you choose other please state here *

Relationship to student *

Mother

Step-mother

Legal guardian

Other (please state)

Who student normally resides with

If you choose other please state here *

Address (if different to student) *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone (landline)

Phone(mobile) *

Email address *

Employer's name

Employer's address *

Phone (work)

Occupation *

Legal Caregiver Details

(Male) Who student normally resides with

Is there a male Legal Caregiver? *

Yes

No

Who student normally resides with

Name *

First

Last

Status *

Solo parent

Single

Married

De-facto

Other (please state)

Who student normally resides with

If you choose other please state here *

Relationship to student *

Father

Step-father

Legal guardian

Other (please state)

Who student normally resides with

If you choose other please state here *

Address (if different to student) *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone (landline)

Phone (mobile)

Email address *

Employer's name

Employer's address *

Phone (work)

Occupation *

Shared Care Details

If shared care exists, please complete the following details for the other parent & their partner below

Is the student in shared care? *

Yes

No

Is there a female other partner/their partner under shared care? *

Yes

No

Is there a male other partner/their partner under shared care? *

Yes

No

Title *

Mrs

Miss

Ms

Mr

Name *

First

Last

Status *

Solo parent

Single

Married

De-facto

Other (please state)

If you choose other please state *

Relationship to student *

Mother

Father

Step-mother

Step-father

Legal guardian

Other (please state)

If you choose other please state *

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone (landline)

Phone (mobile)

Email Address *

Employer's address *

Phone (work) *

Occupation *

Communication

Where mother and father have different addresses, please tick who the primary parent or guardian responsible for daily care is *

Mother

Father

Other Caregiver

Not Applicable

Parents whose addresses are different: Do you require a separate school report? *

Yes

No

Not Applicable

Custody/Access Arrangements

Court order issued *

Yes

No

Not Applicable

Attach further information as required

File Upload *

Court order issued comment, if necessary

Caregivers Details

Complete if student is living with a caregiver while at Ngā Taiātea Wharekura

Is student living with a caregiver while at Ngā Taiātea Wharekura? *

Yes

No

Name *

First

Last

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone (landline) *

Phone (mobile) *

Email address *

Employer's name

Employer's address

Phone (work)

Occupation

Emergency Contact

An emergency contact must be contactable and made aware that they have been selected as a contact for your child, in case of any emergency that may occur while at Ngā Taiātea Wharekura

Name *

First

Last

Phone (landline) *

Phone (mobile) *

Phone (work) *

Relationship to student *

Current address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Please indicate approximate sizing of student

Top size *

Skirt or Short size *

Jersey size *

Parent Approval required

I consent to my child's vision and hearing being tested *

Yes, I consent to my child's vision and hearing being tested

No, I do not consent my child's vision and hearing being tested

I agree for the school nurse to give my child paracetamol/panadol if he or she considers the use of it appropriate for the situation. *

Yes, I agree for the school nurse to give my child paracetamol/panadol if he or she considers the use of it appropriate for the situation.

No, I do not agree for the school nurse to give my child paracetamol/panadol if he or she considers the use of it appropriate for the situation.

I give permission for the school nurse to assist my child by providing a safe and effective health care service, and to assist them in maxmising access to health care opportunities. Parents will be notified when necessary and are welcome to contact the nurse with any queries. *

Yes, I give permission for the school nurse to assist my child by providing a safe and effective health care service, and to assist them in maxmising access to health care opportunities. Parents will be notified when necessary and are welcome to contact the nurse with any queries.

No, I do not give permission for the school nurse to assist my child by providing a safe and effective health care service, and to assist them in maxmising access to health care opportunities. Parents will be notified when necessary and are welcome to contact the nurse with any queries.

I agree for my child's work and/or photo to be used by Ngā Taiātea Wharekura for publishing purposes. *

Yes, I agree for my child's work and/or photo to be used by Nga Taiatea Wharekura for publishing purposes.

No, I do not agree for my child's work and/or photo to be used by Nga Taiatea Wharekura for publishing purposes.

Students from time to time will be involved in Education Outside the Classroom for a period of the school day within the Hamilton districtl I consent to my son's/daughter's involvement. *

Students from time to time will be involved in Education Outside the Classroom for a period of the school day within the Hamilton districtl I consent to my son's/daughter's involvement.

Upload Documents

Please upload a copy of the following documents with this form:

NZ Birth certificate of NZ Passport *

Last school report *

Additional Documents

Upload up to 3 additional documents

Privacy Statement

The school collects the information on these forms to:

enrol your child at school

assess the educational needs of your child

ensure the school gets the correct resources from the Ministry of Education for you child

The school collects and uses your child's information in accordance with the Privacy Act. The school sends some of your child's information to the Ministry of Education and other education and health agencies. The school will not provide your child's information to other people or organisations with your authorisation, except in accordance with the Privacy Act.

Youth Service

The Ministry of Education shares your address and phone number information with the Ministry of Social Development (MSD) as part of the Youth Service initiative. Youth Service identifies young people who may have difficulty finding future employment, training or further education. Youth Service uses the contact information to find these young people and support them into education or training when they leave school.

Accessing or changing your information

Contact the school if you want to view or change your child's information.